1780611681 NPI number — RONALD A BROWNING MD

Table of content: RONALD A BROWNING MD (NPI 1780611681)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780611681 NPI number — RONALD A BROWNING MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BROWNING
Provider First Name:
RONALD
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1780611681
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/20/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 5037
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JOPLIN
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64803-5037
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
417-781-9200
Provider Business Mailing Address Fax Number:
417-781-9471

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3202 MCINTOSH CIRCLE
Provider Second Line Business Practice Location Address:
STE 101
Provider Business Practice Location Address City Name:
JOPLIN
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64804
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
417-781-9200
Provider Business Practice Location Address Fax Number:
417-781-9471
Provider Enumeration Date:
06/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  34965 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 110106826 . This is a "RR MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9230 . This is a "ANTHEM" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 100153800B , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200113306 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100183870A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00810745 . This is a "RR MEDICARE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".




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